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When treatment becomes risk: polypharmacy and inappropriate prescribing in cognitive impairment in 2379 consecutive patients from a memory clinic.

Created on 25 Aug 2026

Authors

Xavier Morató, Adrian Hinojosa-Calleja, Sara Jofresa, Berta Calm, Amanda Cano, Josep Blazquez-Folch, Emilio Alarcón-Martín, Laura Montrreal, Álvaro Muñoz-Morales, Claudia Olivé, Paula Bayón, Oscar Sotolongo-Grau, Adelina Orellana, Pilar Sanz-Cartagena, Xavier Montalban, Marta Marquié, Maria Victoria Fernandez, Agustín Ruiz, Mercè Boada, Sergi Valero

Published in

Alzheimer's & dementia : the journal of the Alzheimer's Association. Volume 22. Issue 8. Pages e71708.

Abstract

Polypharmacy, potentially inappropriate medications (PIMs), and drugs associated with drug-induced cognitive impairment (DICI) are highly prevalent in older adults and may affect cognitive decline.
This observational retrospective study included 2379 patients evaluated at Ace Alzheimer Center Barcelona. Medication data were extracted from electronic health records using a large language model (LLM). Polypharmacy (≥5), hyperpolypharmacy (≥10), PIMs, and DICI drugs were analyzed across cognitive stages, Alzheimer's disease biomarkers, ApoE subtype, and estimated glomerular filtration rate.
Among patients with cognitive impairment (Clinical Dementia Rating [CDR] ≥ 0.5), 67% presented polypharmacy and 21% hyperpolypharmacy. Higher odds of polypharmacy were observed across the CDR scale, while higher education showed a protective effect. Altered renal function was found in 20.8% of patients with polypharmacy. Indeed, significant differences were found between amyloid beta-positive and negative (Aβ+/Aβ-) subjects and between the whole population and subjects participating in clinical trials.
Polypharmacy is extremely common in patients attending memory clinics. LLMs could facilitate systematic structured medication reviews.

PMID:
42639919
Bibliographic data and abstract were imported from PubMed on 25 Aug 2026.

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